Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4.5X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705158
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

SCREW 4.5X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705158
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW 4.5X16MM CERES-C SLF TAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692580
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW 4.5X16MM CERES-C SLF TAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692580
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

SCREW 4.5X18MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705132
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

SCREW 4.5X18MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705132
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW 4.5X 25MM

Facility

$533.35

Service Code	HCPCS C1713
Hospital Charge Code	270704982
Hospital Revenue Code	278
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$266.68
Rate for Payer: Aetna Commercial	$202.67
Rate for Payer: Aetna Medicare Advantage	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.00
Rate for Payer: Cigna Commercial	$266.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.07
Rate for Payer: Qualcare PPO/HMO/WC	$80.00
Rate for Payer: UnitedHealthcare Community & State	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$15.15

SCREW 4.5X 25MM

Facility

$533.35

Service Code	HCPCS C1713
Hospital Charge Code	270704982
Hospital Revenue Code	278
Min. Negotiated Rate	$80.00
Max. Negotiated Rate	$129.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.07
Rate for Payer: Qualcare PPO/HMO/WC	$80.00

SCREW 4.5X26MM

Facility

$735.00

Service Code	HCPCS C1713
Hospital Charge Code	270704442
Hospital Revenue Code	278
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$177.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

SCREW 4.5X26MM

Facility

$735.00

Service Code	HCPCS C1713
Hospital Charge Code	270704442
Hospital Revenue Code	278
Min. Negotiated Rate	$20.87
Max. Negotiated Rate	$367.50
Rate for Payer: Aetna Commercial	$279.30
Rate for Payer: Aetna Medicare Advantage	$220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.43
Rate for Payer: Cigna Commercial	$367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: Qualcare PPO/HMO/WC	$110.25
Rate for Payer: UnitedHealthcare Community & State	$23.23
Rate for Payer: Wellpoint Medicaid Managed Care	$20.87

SCREW 4.5X30MM

Facility

$3,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270704441
Hospital Revenue Code	278
Min. Negotiated Rate	$104.37
Max. Negotiated Rate	$1,837.50
Rate for Payer: Aetna Commercial	$1,396.50
Rate for Payer: Aetna Medicare Advantage	$1,102.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$937.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$937.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$937.12
Rate for Payer: Cigna Commercial	$1,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.35
Rate for Payer: Qualcare PPO/HMO/WC	$551.25
Rate for Payer: UnitedHealthcare Community & State	$116.13
Rate for Payer: Wellpoint Medicaid Managed Care	$104.37

SCREW 4.5X30MM

Facility

$3,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270704441
Hospital Revenue Code	278
Min. Negotiated Rate	$551.25
Max. Negotiated Rate	$889.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.35
Rate for Payer: Qualcare PPO/HMO/WC	$551.25

SCREW 4.5X38MM

Facility

$5,460.00

Service Code	HCPCS C1713
Hospital Charge Code	270684552
Hospital Revenue Code	278
Min. Negotiated Rate	$155.06
Max. Negotiated Rate	$2,730.00
Rate for Payer: Aetna Commercial	$2,074.80
Rate for Payer: Aetna Medicare Advantage	$1,638.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,392.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,392.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,392.30
Rate for Payer: Cigna Commercial	$2,730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.32
Rate for Payer: Qualcare PPO/HMO/WC	$819.00
Rate for Payer: UnitedHealthcare Community & State	$172.54
Rate for Payer: Wellpoint Medicaid Managed Care	$155.06

SCREW 4.5X38MM

Facility

$5,460.00

Service Code	HCPCS C1713
Hospital Charge Code	270684552
Hospital Revenue Code	278
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$1,321.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.32
Rate for Payer: Qualcare PPO/HMO/WC	$819.00

SCREW 4.75 EXTTAB CAN 6.5X40MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699276
Hospital Revenue Code	278
Min. Negotiated Rate	$189.43
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$210.77
Rate for Payer: Wellpoint Medicaid Managed Care	$189.43

SCREW 4.75 EXTTAB CAN 6.5X40MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699276
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

SCREW 4.75 EXTTAB CAN 6.5X45MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699280
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

SCREW 4.75 EXTTAB CAN 6.5X45MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699280
Hospital Revenue Code	278
Min. Negotiated Rate	$189.43
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$210.77
Rate for Payer: Wellpoint Medicaid Managed Care	$189.43

SCREW 4MM

Facility

$415.00

Service Code	HCPCS C1713
Hospital Charge Code	270680774
Hospital Revenue Code	278
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$100.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

SCREW 4MM

Facility

$415.00

Service Code	HCPCS C1713
Hospital Charge Code	270680774
Hospital Revenue Code	278
Min. Negotiated Rate	$11.79
Max. Negotiated Rate	$207.50
Rate for Payer: Aetna Commercial	$157.70
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.25
Rate for Payer: UnitedHealthcare Community & State	$13.11
Rate for Payer: Wellpoint Medicaid Managed Care	$11.79

SCREW 4 X 14 MM

Facility

$875.00

Hospital Charge Code	270702969
Hospital Revenue Code	278
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

SCREW 4 X 14 MM

Facility

$875.00

Hospital Charge Code	270702969
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW 4X14MM

Facility

$13,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704158
Hospital Revenue Code	278
Min. Negotiated Rate	$1,987.50
Max. Negotiated Rate	$3,206.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,206.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50

SCREW 4X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705705
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW 4X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703038
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

Know your out-of-pocket cost for care.

All Charges